Feline and Canine Vestibular Disease
Veterinarian Approved on May 27, 2015 by Dr. Janice Huntingford
Vestibular disease is a disruption in the balance, or vestibular, system of a dog or cat. This system has components in the inner ear and the brain. It is responsible for determining what position the animal is in and telling his eyes and extremities how to respond in relation to it. When something interferes with this system, the animal does not know whether his body is right-side up, upside down, or falling. This results in sudden, alarming, balance-related issues.
Signs of Vestibular Disease in Dogs and Cats
The following signs, all common when the vestibular system of an animal is disrupted, lead many people to fear that their pet has had a stroke:
- Ataxia: This is the lack of coordination and the tendency to fall over.
- Motion sickness: Vomiting is common during episodes of vestibular disease, as a result of the dizziness associated with disruption in balance.
- Head tilt: The pet’s head tilts to the side, and he is unable to hold it straight. This head tilt is usually in the direction of the lesion causing the vestibular disease.
- Nystagmus: This is the rapid movement of the eyes from side to side. One phase of this movement is usually faster than the other and it is named for this direction. If the left phase of the eye movements is faster, it will be labeled as a left nystagmus. The lesion causing the vestibular disease is generally on the opposite side of the body as the fast phase of the nystagmus.
- Circling: Moving continuously in a circle rather than a straight line is commonly seen during vestibular disease. Circling is also usually in the direction of the lesion. This can also be seen as rolling around on the ground.
- Loss of control of facial muscles.
Causes of Vestibular Syndrome in Dogs and Cats
The most common causes of vestibular disease in pets are:
- Brain lesions. These can include tumors or infections in the brain. This type of vestibular disease is termed “central.”
- Inner ear infections. Ear infections are very common in dogs, especially those with long, floppy ears or those with food allergies. This type of vestibular disease is known as “peripheral”.
- Idiopathic causes. These are cases where the origin of the vestibular disease is unknown, and it is the most common cause of this syndrome in dogs and cats.
Diagnosis of Vestibular Disease in Dogs and Cats
When vestibular disease occurs, it is important to determine what area is causing the problem if possible. Is it central or peripheral? The following signs offer clues that the pet’s problem is central, in the brain:
- Facial nerves such as those that control the face, ear, eye, or tongue on the side opposite to the head tilt are disrupted.
- The animal’s nystagmus is vertical (up and down) rather than horizontal (side to side).
- The nystagmus is only present when the animal is placed into certain positions.
- The pet has proprioceptive deficits (e.g. is unable to turn his foot right-side up when it is turned upside down).
Sometimes only a CT scan or MRI can determine whether a brain lesion is present.
The following are clues that the pet’s vestibular disease may be peripheral, or inner ear, in origin:
- The animal has a history of ear infections.
- Debris is seen in the pet’s ear when it is examined with an otoscope.
- There are signs of facial nerve paralysis and a droopy eye on the same side as an ear that is reddened, swollen, or contains debris.
The good news is that most cases of vestibular disease in dogs and cats are idiopathic. Idiopathic vestibular disease is peripheral, not central. It comes on very suddenly with the worst signs occurring in 24 to 48 hours. There is no weakness and there are no proprioceptive deficits. In most cases the dog is a geriatric and has no signs of ear infections. It is not progressive and spontaneous remission of signs occurs in a few days to weeks. Some pets are left with residual signs such as a head tilt or weakness.
When presented with pets that have signs of vestibular disease, but no obvious inner ear infection, many veterinarians will run some basic blood and urine tests. If these tests are normal, it is reasonable to wait a few days to see if the pet’s signs improve. If the tests are abnormal, or a brain lesion is suspected, referral to a specialist may be recommended.
Treatment of Vestibular Syndrome in Cats and Dogs
Conventional treatment for vestibular disease in pets consists of anti-nausea medication, nursing care (bringing food and water to the pet, carrying him outside, and steadying him for urination and defecation), and time. However, holistic treatments can speed your pet’s recovery.
Acupuncture combined with physical therapy, homeopathic medications, vitamin supplements, and herbs may decrease the recovery time in cases of idiopathic vestibular disease. With this combination, there is usually improvement within a few days. Even if you do nothing else but stand the pet up for five minutes every hour so his feet are touching the ground, you will see some improvement.
Many people mistake the signs of vestibular disease for signs of stroke in their pets and fear that euthanasia is necessary because the pet can not get around on his own. Stroke is quite rare in pets, and vestibular disease usually resolves quickly. It is extremely important to support these pets and give them time to recover. It is not a reason for euthanasia.
Janice Huntingford, DVM, has been in veterinary practice for 28 years and has founded two veterinary clinics since receiving her Doctor of Veterinary Medicine at the Ontario Veterinary College, University of Guelph. She has studied extensively in both conventional and holistic modalities. Ask Dr. Jan